Summer is basically my spirit animal. Arizona gets a bad rep for it’s 120+ degree summers, but it’s the best time of the year to be in the water! Swimming, kayaking, paddle boarding, jet skiing, cliff jumping, snorkling… Being in the water is the best, but if you have diabetes it can present a certain set of challenges. You can still do all of the fun summer things if you have diabetes, you just have to keep a few extra things in mind.

Pumping it

A lot of people with diabetes manage it with an insulin pump, myself included. If you are lucky enough to have an Omnipod, you already have a swimming, surfing, beach-proof method for managing your diabetes. (If you haven’t heard of it, here’s the Omnipod) For other pumps, you have to plan a little differently.

• Water and pump sites don’t seem to be friends. Make sure you tape your site down and bring extra site (or a few) in case it falls out. Waterproof band-aids or waterproof sports tape tends to work the best. I use a skin adhesive called Skintac and adhesive tapes from Expressionmedtape to make sure my sites and devices stay on.
• Don’t let your insulin pump fry in the sun. When you take it off to get in the water, make sure it is in a cool place. Best case scenario, you have a cooler with food in it that you can place the insulin pump on top (don’t let it get down in the ice or water—that would defeat the whole purpose!) If you don’t have a cooler, make sure to place the pump in the shade. And keep in mind that the insulin could go bad if it gets too hot, so if you have some unexplained high blood sugars that night or next day, change out your insulin.
• Plug in periodically! Your pump gives you your basal insulin—the oh-so important drip of insulin you need to stay alive. If you have the pump off all day and have no insulin in your system, even if you are active, you could have high blood sugars or go into DKA. So when you’re taking a break from the waves, plug in to get some basal action.
• Keep your pump safe. A lot of beach activities involve setting up your stuff, then everyone going out into the water. It’s always a bummer if things get stolen, but if your pump gets stolen, that’s kind of a big deal. Put your pump somewhere where it is locked away, like in the car if the car isn’t going to get too hot, or make sure someone is staying with your stuff.
• I also recommend bringing insulin and a few syringes in case your site rips out (and in case your extra sites rip out too) or your pump fails. It would be a major bummer to be in the middle of a perfect day at the beach and all of a sudden have no insulin and no back-up plan.

Shots

Lately I’ve been using a tslim X2 pump, which is amazing, but it has tubing, so if I’m spending the day or weekend in the water, I’ll take a pump break. I love going back on shots during beach or river trips because you don’t have to worry about plugging in, leaving your pump alone, or figuring out where to put it when you go kayaking.

• Keep your insulin cool. If you have a cooler, great. If not, I recommend a Frio insulin case. This bad boy was designed to keep insulin the right temperature. It has little absorbent beads in it and works by evaporative cooling, so you can bring it along anywhere. They come in two sizes, a Large Frio for trips without constant fridge access, and a Small Frio for quick trips to the beach.
• With shots and on a pump, be aware of your insulin’s peak time. It’s usually around 1.5 hours after you give it. Exercise will metabolize the insulin faster, so if you eat, give an insulin dose, then go out paddle boarding, watch out for a hypo around the time your insulin peaks.

Water Sports!

• If you are out in the water doing water sports, you may need less insulin. Surfing, paddle boarding, kayaking, swimming, you name it-it’s going to take a lot of energy. If you are on a pump, consider a temporary basal (to decrease your insulin for a few hours). If you’re on long-acting, consider taking a lower dose the day you are going to be extremely active.
• And don’t forget your snacks! If you haven’t lowered your insulin or if you’re going to be hitting it hard in the water, have a carb + protein snack before going out to make sure your sugars stay up.
• I can’t stress this one enough: Waterproof cases are your friend. If you’re doing water activities like kayaking, wind-surfing where you will be out on the water for an extended period of time, you’re going to want to take your pump, meter and whatever supplies you need. On our first trip out of the country, I dropped my pump, CGM and meter in the water at the beach and it was all completely ruined. Learn from my mistakes. Even if you are just walking along the beach looking for sea-shells, keep your supplies safe. You can buy waterproof cases at any sports store or online.

• How do you diabetes and go snorkeling? Unlike kayaking or paddle boarding, you can’t really keep your stuff with you while you snorkel. Even if you’re on a CGM, it probably won’t pick up if you’re in the water the whole time. I’d recommend testing before you go out and running your sugar a little bit higher or having a snack. Fruit snacks also make perfect snorkeling low snacks because it’s waterproof and you can stuff it in your swim suit in case you need to sugar-up when you’re in the water!

General Tips

• Hydration is important for everyone, but especially if you have diabetes. If you’re in the water, you can forget to drink water. But getting dehydrated can cause stubborn high blood sugars.
• Carb counting is always kind-of a pain, but especially when you want to relax on the beach. Make it easy for yourself and pre-pack snacks with known numbers of carbs.

• If you’re going to be drinking alcohol at the pool, pay special attention to your blood sugars. Drinking with diabetes is a blog post-worthy topic in itself, so I’ll just say a little bit here. Cocktails and beer tend to have carbohydrates, which will make your blood sugars go up, so you will probably need to take some insulin. They will also make you pay less attention to your blood sugars, so you might miss a low blood sugar. Make sure you stay aware of your sugars and make sure the friends you are hangin’ by the pool with know you have diabetes—you want them to be able to know if something might be off with your diabetes vs. someone who just drank too much. Additionally, alcohol can make your sugars go lower way later—like 6-8+ hours later, so keep close watch for lows the night after.

Summer is the best. Have a fun time hanging pool side and let me know if you have any other tips or tricks for managing diabetes in the water!